application form 2015

_______________________________________________________________

APPLICATION FORM ______________________________________________________________

COMMON MEMBERSHIP FOR (Please Tick _/ )

All India Council Of Human Rights , Liberties & Social Justice

National Council of News & Broadcasting (PRESS) (NCNB)

National Legal Council (NLC) ,(An unit of AICHLS)

All India Anti Corruption Council (AIACC) ,(An unit of AICHLS)

All India Consumer Protection Council (AICPC), (An unit of AICHLS)

International Institute of Human Rights Studies) IIHRS ,(An unit of AICHLS)

Submit the complete form with the following documents and send to us on the below address for selection

Selection process time 7/10 days

1. 4 Nos. Passport Size Photo 2. Address Proof & Photo ID Proof 3. DD/Bank Deposit/NEFT Slip For Your Document Preparation 4. Self Address Envelope ( A-4 Size ) With Complete Address , Mobile No. / Pin Code . 5. Paste your passport photograph with front face in all Forms.

_______________________________________________________________

CONTACT / POSTAL ADDRESS

SECRETARY GENERAL

All India Council Of Human Rights, Liberties & Social Justice Central Office: H-10, Basement, NDSE - Part One , New Delhi 110 049

phone: 011 65152233, 9873087903, 9873005424 Email: [email protected]

visit: www.humanrightscouncil.in , news : www.newsindiatoday.tv

www.facebook.com/allindiacouncilofhumanrights

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE

(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

COMMON FORM FOR AICHLS/NLC/AICPC/AIACC

To,

Chairman Central Selection Committee

New Delhi.

MEMBERSHIP FORM

(FILL THE FORM WITH CAPITAL LETTER ONLY)

Applicant Name (BLOCK LETTER) : ___________________________________________

Fathers Name : ___________________________________________

Date Of Birth : ___________________________________________

Mobile :________________ Landline with STD Code :_________

Email ID ( Capital Letter Only) : ___________________________________________

Residence Address Permanent : ___________________________________________

Postal Address Present (BLOCK LETTER) : ___________________________________________

Qualification : ___________________________________________

I declare, that I am joining the organization with my own acceptance and consent and not been forced by anyone and

want to help the organization to serve the society with dignity, will not do any illegal activity which against the

Indian law , Indian constitution and society

Please Provide Three References:

1. Name____________ Mobile__________ Relationship____________Email Id______________



Signature Applicant : _________________ Date ___________________

Official Use Only

The national selection committee has examined your all details and hereby approve / disapprove your Application

For The Membership.

Membership No. : ___________________________

Designation Granted : ___________________________

Signature /Date Signature/Date

Chairman (Selection Committee) National President/Chairman

Paste your Photo Here



MUST ANSWER THESE QUESTION FOR VERIFICATION

What is your Email Id ( CAPITAL LETTER ONLY) : ________________________________

What is your exact Mobile No. : ________________________________

What is your Land Line No. ( with STD Code) : ________________________________

What is your profession :_______________________________________________________

Are you married or unmarried : ________________________________

(If Married) : Spouse name : ________________________________

How many kids do you have ? : ________________________________

What is your objective to join this organization?

_____________________________________________________________________________

How do you want to serve the society?

_____________________________________________________________________________

How you came to know about us ?

_____________________________________________________________________________

Do you know any exisitng member in said organization If Yes ( Provide Name , Address ,

Mobile , Email Id. ) : ___________________________________________________________

_____________________________________________________________________________

Are you joining with your own consent? : Yes / No : _________________________________

Have you ever been pressurized by any existing member or anybody to become part of our

AICHLS/NCNB/NLC/AICPC/AIACC: Yes / No : ____________________________________

Have you ever been convicted by any court in India : Yes / No.: _________________________

Have you ever involved with any activity which is against the Indian Government / Government

Policy / Indian Law / Constitution: Yes / No. : _________________________________

Have you ever been involved with any human rights activity (Brief)

_____________________________________________________________________________

_____________________________________________________________________________

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Are you ready to serve the society voluntarily / without Any remuneration / Commission / Salary

etc.? : Yes/ No : _________________________________

At what level (International/National/State/District/Block/ward/Taluka ) are you ready to take

responsibility & How many membership can you generate from your social network? :

_____________________________________________________________________________

Are you ready to make your working / action committee at the earliest : Yes/ No : _________

within how many days? : _________

Are you suffering with any kind of disease: Yes/ No : _________________________________

Are you ready to submit all your written report every month: Yes/ No : ___________________

What is the issue which you want to work in the said organsiation ? (Ex. Child Labor, Education Etc.)

_____________________________________________________________________________

Have you made any donation /contribution in said organsiation ? Yes / No

If Yes ( Please mention the amount) : Rs. _________________________

(In Word : Rs. ___________________________________________________________)

Mode of Payment (Cash/Cheque/DD/PO) : ____________________________

Collected by (Name of person & Mobile No.) : ____________________________

Have you asked to pay Cash /Cheque/DD/PO : ____________________________

How much have you paid for your documentary charges : Rs. _____________________

DECLARATION: I hereby solemnly affirm and declare that The particulars mentioned by me here in

above are true & correct to the best of my knowledge and belief and nothing has been concealed or

suppressed thereof. If anything found incorrect at any stage, my membership may be terminated. I

honestly declare that I will not involve myself directly or indirectly in any act which will be against the

prestige of our Indian Policy , Indian Government , Nation , Constitution , Indian Laws, Society,

Journalism and AICHLS/NCNB/NLC as well. I will abide by the rules and regulations and Byelaws of

the AICHLS/NCNB/NLC in force from time to time.

Signature (Applicant only)

Name_____________________ Date____________Location_________Mobile ___________________



_____________________________________________________________________________

NATIONAL COUNCIL OF NEWS & BROADCASTING

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00810/NE


To,

Chairman / Editor in Chief

Central Selection Committee

MEMBERSHIP FORM

(FILL THE FORM WITH CAPITAL LETTER ONLY)

Applicant Name : _______________________________________________________

Fathers Name : _______________________________________________________

Date Of Birth : _______________________________________________________

Mobile :________________ Landline with STD Code :________________

Email ID ( Capital Letter Only) : _________________________________________

Residence Address Permanent : _________________________________________

Postal Address Present (BLOCK LETTER) : _____________________________

Qualification : _________________________________________

I declare, that I am joining the organization with my own acceptance and consent and not been

forced by anyone and want to help the organization to serve the society with dignity, will not do

any illegal activity which against the Indian law , Indian constitution and society

Please Provide Three References :




Signature Applicant : _________________ Date ___________________

Official Use Only

The national selection committee has examined your all details and hereby approve / disapprove

your Application For The Membership.

Membership No. : ___________________________

Designation Granted : ___________________________

Signature /Date Signature/Date

Chairman (Selection Committee) National President/Chairman


(OATHS/ACCEPTANCE/DECLARATION (ONLY AICHLS/NCNB/NLC/AICPC/AIACC APPLICANT)

To, Chairman

Central Selection Committee

Dear Sir,

I_______________________S/o_________________ Residence of _______________ Solemnly

take oaths / accept and declare:

1. That I am joining and subscribing AICHLS/NCNB/NLC/AICPC/AIACC with my own consent

without any force or pressure from any existing member of

AICHLS/NCNB/NLC/AICPC/AIACC or from any source related to the Org.

2. That I shall render my all services to the AICHLS/NCNB/NLC/AICPC/AIACC free of cost on voluntarily basis, without claiming any kind of payments or service charges or expenses.

3. That I shall be fully dedicated to Human rights, Liberties and social Justice for the people & society and not for individual or my own benefits.

4. That I shall not misuse the name of AICHLS/NCNB/NLC/AICPC/AIACC for my own sake and benefits Strictly, if found liable to face action by CENTRAL DISCIPLINE ACTION COMMITTEE OR NATIONAL PRESIDENT, which is final.

5. That I shall pay all my membership fee , joining fee , Contribution, subscription in time and with my own acceptance , consent and agreement.

6. That I shall obey and respect the code of conduct and constitution of the AICHLS/NCNB/NLC/AICPC/AIACC in all mode and all time.

7. That AICHLS/NCNB/NLC/AICPC/AIACC shall not be responsible , for any kind of my illegal

activities, court cases, functions, seminars , rally which against the Indian Government /

Government Policy / Indian Law / Constitution/ society, knowingly or unknowingly and I shall be terminated from AICHLS/NCNB/NLC/AICPC/AIACC by immediate effect, without any

notice and accept the final decision of the CENTRAL DISCIPLINE ACTION COMMITTEE OR

NATIONAL PRESIDENT.

8. That I shall authorize AICHLS/NCNB/NLC/AICPC/AIACC to put my name & details on the website i.e. www.humanrightscouncil.in or any related social site or web site.

9. That I shall attend all meetings of the AICHLS/NCNB/NLC time to time in my respective jurisdiction.

10. That I shall the serve the AICHLS/NCNB/NLC/AICPC/AIACC with whatever responsibility and accountability given to me.

11. That I understand, my membership is non-transferable , provisional and once the payment is made, it is non-refundable.

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12. That mine any kind of misbehavior or misconduct or anti society activity may result in rejection/termination of my membership of AICHLS/NCNB/NLC/AICPC/AIACC.

13. That I shall renew my membership within 30 days immediately after expiry. In case of change of address, I will inform the same to the National Administration Office .

14. That in case of loss of the identity Card, I will inform the Police Station , National Administration Office in writing along with the F.I.R. immediately.

15. That being member of AICHLS/NCNB/NLC/AICPC/AIACC , shall contact my respective Area Units / State Units / National Administration Office once in a month and send a written report /

Email.

16. That I am ready to face Strict action , if found guilty floating the rules and regulations of AICHLS/NCNB/NLC/AICPC/AIACC, and are also punishable under the Press & Societies Act.

17. If I am holding the press ID card , I will report all the incidents immediately to the NCNB and voluntarily.

18. If I am holding the Legal ID card , I will serve the people absolutely free and voluntarily and provide free legal advice time to time.

19. If I have any doubt, question or problem, will contact AICHLS/NCNB/NLC/AICPC/AIACC National Administration Office with the All rights reserved to

AICHLS/NCNB/NLC/AICPC/AIACC.

20. That my membership / designation / position are provisional , but membership shall remain valid for 12 months as given your ID card.

21. That all disputes subject to Delhi Jurisdiction only. 22. That I shall take pre-approval from Delhi Head office before doing any correspondence with

Government / Local Administration.

23. That I have not been convicted by any court in India.

DECLARATION: I hereby solemnly affirm and declare that The particulars mentioned by me here in

above are true & correct to the best of my knowledge and belief and nothing has been concealed or

suppressed thereof. If anything found incorrect at any stage, my membership may be terminated. I

honestly declare that I will not involve myself directly or indirectly in any act which will be against the

prestige of our Indian Policy , Indian Government , Nation , Constitution , Indian Laws, Society,

Journalism and AICHLS/NCNB/NLC as well. I will abide by the rules and regulations and Byelaws of

the AICHLS/NCNB/NLC in force from time to time.

Signature (Applicant only)


Signature (Reference only)




PERSONAL DETAIL FOR MAKING DOCUMENTS

COMMON FORM FOR AICHLS/NCNB/NLC

Kindly fill the details with CAPITAL LETTER, we will not responsible for any spelling mistake their

after , I am giving my particulars to make my Identity Card / Certificate / Car Sticker etc. as

details are given below , I am fully responsible for any spelling mistake if found in this slip and I

have submitted my full documents charges ( Voucher Details attached)

ONLY CAPITAL LETTER TO BE FILLED ( EMAIL ALSO :

([email protected] )

Applicant Name : _________________________________________________

Fathers Name : _________________________________________________

Spouse Name : _________________________________________________

Date Of Birth : _________________________________________________

Mobile : _________________________________________________

Landline with STD : _________________________________________________

Email ID (Capital Letter Only) : : _________________________________________________

Blood Group : _________________________________________________________________

Emergency Contact No : _________________________________________________

Complete Residence Address Permanent with pin code

______________________________________________________________________________

______________________________________________________________________________

Complete Residence Address Present with pin code

______________________________________________________________________________

Write your Complete Address with pin code (For Delivery The Documents))

______________________________________________________________________________

______________________________________________________________________________




Expense Slip (Treasury dept)

Documents & Administrative Charges (Must mention)

Particulars (Documentary Charges) Amount Dated Bank Drawn

All India Council Of Human Rights , Liberties & Social Justice

All India Identity Card (Plastic) and Certificate. (AICHLS)

Rs. 1175/-

National Council of News & Broadcasting (PRESS) (NCNB)

www.newsindiatoday.tv

All India PRESS REPRESENTATIVE CARD and Certificate.

Rs.

975 + 2125

= 3100 /-

National Legal Council (NLC)

(A Legal Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)

All India Identity Card (Plastic) and Certificate.

Rs. 1575/-

All India Anti Corruption Council (AIACC)

(An Anti Corruption Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)


Rs. 1275/-

All India Consumer Protection Council (AICPC)

(A consumer protection Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)


Rs. 1375/-

Car / Bike Sticker (Cost per sticker) Rs. 225/-

International Institute of Human Rights Studies ) IIHRS

(A Educational Wing of All India Council Of Human Rights , Liberties &

Social Justice) , provides Diploma as a HONOUR

Diploma Human Rights (Honour) No Examination

Post Graduate Diploma (Honour) No Examination

Rs. 3100/-

Rs.5100/-

Special Donation

Special Contribution

Donation for eye operation/food/medicine/orphanage/old age

etc.



Kindly Note :

1. All Contribution /Donations movable or immovable exempted granted registration under section -80 (G) (5) (vi) & 12A of the Income Tax Act, 1961 by the Directorate of Income

Tax (Exemptions), New Delhi

2. Kindly speak to us for press card before applying at Editor - 98730 87903 3. Kindly note that we do not accept or receive Cash, inform us if anyone is asking for Cash

98730 87903 or Email : [email protected]. 4. After receiving the sets of documents, Kindly send the photocopy of your documents at

Delhi Office and must check your name on our web site (www.humanrightscouncil.in ) ,

if not there kindly intimate us / Email : [email protected].

5. Primary membership is Free only documents making and administrative charges to be paid as given above , which is non refundable.

6. Read all our aims , objectives, achievements , Roles & Responsibilities in ABOUT US column.(www.humanrightscouncil.in)

7. Contribution /Donations/Fees Etc. To Be By DD/PAY ORDER In The Favour of ALL INDIA COUNCIL OF HUMAN RIGHTS,LIBERTIES & SOCIAL JUSTICE and NATIONAL COUNCIL OF NEWS & BROADCASTING payable New Delhi

FOR ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

INDIAN BANK:

Saving A/c No. : 6106 880946 payable New Delhi

Branch Address: South Extension -I, New Delhi

CBS Code: 00361 - IFS Code: IDIB000 S032

HDFC BANK - Branch Defence Colony - New Delhi Saving A/c No. : 1092 145 0000069 payable New Delhi

RTGS/NEFT IFSC : HDFC0001092

Online Transfer: Please email us the transit number of online transfer

FOR PRESS REPRESENTATIVE CARD

NATIONAL COUNCIL OF NEWS & BROADCASTING

HDFC BANK - Branch Defence Colony - New Delhi Saving A/c No. : 1092 145 0000052 payable New Delhi

RTGS/NEFT IFSC : HDFC0001092

8. If Depositing Money or NEFT in the bank, mail us your deposit /NEFT details at [email protected]

9. FOR ANY QUERY : 9.00AM TO 9.00 PM : 9873005424 / 9873087903

